• Read more about Attention Pharmacy Providers: Status of Restoration of Maine Point of Purchase System (MEPOPS) and Office Hours with MaineCare’s Pharmacy Team

The Office of MaineCare Services continues a phased recovery following the outage that occurred from February 21, 2024, through March 26, 2024, due to the national cyber security issue affecting Change Healthcare. 

We are entering the next phase of the recovery and are continuing to restore waived edits. On May 1, 2024, Reject – 79 Refill Too Soon and Reject-79 Refill Too Soon Carryover were returned to normal functioning. On July 17, 2024, Reject-76 Plan Limitations Exceeded, returned to normal functioning.   

• Read more about Attention MaineCare Providers: Notice of Returning Pharmacy Processes Including Prior Authorizations

The Office of MaineCare Services continues a phased recovery following the outage that occurred from February 21, 2024, through March 26, 2024, due to the national cyber security issue affecting Change Healthcare. 

During the outage, limitations were waived regarding medications that were refilled too soon. On May 1, 2024, Reject–79 Refill Too Soon and Reject-79 Refill Too Soon Carryover were returned to normal functioning.  

• Read more about Skin Substitutes no Longer Require a Prior Authorization (PA) - CR 126315

Effective August 1, 2024, skin substitute products no longer require a PA. Providers are expected to select the most appropriate product for treatment and to use the products for the purposes for which they have FDA approval. 

For questions, please contact your Provider Relations Specialist.  

• Read more about Health PAS Online Portal – New: Member Renewal Date Now Available, CR 119276

In July 2024, MaineCare updated the Health PAS Online Portal to include the member’s renewal date, when available, so that providers can more accurately assess the status of a member’s eligibility. Please note the following updates about the eligibility renewal date field:  The new field shows the renewal date of members whose date has been finalized.

• Read more about USDA to Distribute Oral Rabies Vaccine for Wildlife in Northern Maine

Annual bait distribution aims to reduce spread of disease among raccoons

• Read more about Registration is Open for the MaineCare 2024 Delivery System Reform (DSR) Forums

Registration is now open for MaineCare's DSR Annual Forums for:

• Accountable Communities (AC),
• Behavioral Health Homes (BHH),
• Community Care Teams (CCT) including Housing Outreach and Member Engagement (HOME) providers,
• MaineMOM,
• Opioid Health Homes (OHH), and
• Primary Care Plus (PCPlus) providers.    

MaineCare is offering two venue/date options this year. Both sessions will run from 9:00 AM to 4:00 PM. 

• Read more about Maine CDC Identifies West Nile Virus in Six Wild Birds

Maine people and visitors urged to take precautions against bites during active mosquito season

AUGUSTA--The Maine Center for Disease Control and Prevention (Maine CDC) announced today that six wild birds from multiple counties tested positive for West Nile virus (WNV). This is the earliest in the year that Maine CDC has found the mosquito-borne virus in birds.

• Read more about TANF 120 Proposed Rule - Step Disregard, Chapter IV

CHAPTER NUMBER AND RULE TITLE: 10-144 C.M.R. Chapter 331; Public Assistance Manual Temporary Assistance for Needy Families (TANF) – Chapter IV

TANF Rule #120 – Step Disregard

The proposed rule changes would update the Public Assistance Manual Temporary Assistance for Needy Families (TANF) consistent with a legislative change to 22 M.R.S. § 3762 made by P.L. 2023, Ch. 29, An Act to Improve Family Economic Security Under the Temporary Assistance for Needy Families Program.

• Read more about Electronic Visit Verification (EVV) Online Training Available

There are no additional live trainings for EVV scheduled after April 25, 2024. Providers can request Ad Hoc EVV Training by emailing MihmsTraining@gainwelltechnologies.com to schedule a training.

Register for online trainings through Absorb: 

• Read more about Hospital Billing Changes for Days Awaiting Placement (DAP)

MaineCare plans to make the following changes retroactive to July 1, 2024. These changes pertain to claims submitted with a “from” date of service of July 1, 2024, and forward. 

DAP Revised: